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目的 观察人巨细胞病毒(HCMV)在动脉粥样硬化病变中的致病作用,并探讨其相关的临床意义.方法 收集2009年12月至2012年4月诊治的动脉粥样硬化患者134例(观察组),其中冠心病(CHD)患者102例,非CHD患者32例,将102例CHD患者根据HCMV检测结果分为HCMV感染组86例和非HCMV感染组16例,另选取健康体检者40例作为对照组.采用多普勒超声检测颈动脉内膜-中层厚度(IMT),酶联免疫吸附试验法检测血清HCMV-IgM. 结果 观察组HCMV阳性率为77.6％(104/134),显著高于对照组的37.5％(15/40),差异有统计学意义(P＜0.05).观察组中CHD患者和非CHD患者HCMV阳性率分别为84.3％(86/102)和56.2％(18/32),差异有统计学意义(P＜0.05).HCMV感染的动脉粥样硬化患者颈动脉IMT为(1.31 +0.28) mm,显著高于非HCMV感染的(1.14+0.21) mm,差异有统计学意义(P＜0.05).HCMV感染组患者心肌梗死和冠状动脉多支病变的发生率分别为39.5％(34/86)、43.0％ (37/86),显著高于非HCMV感染组的25.0％(4/16)、18.8％(3/16),差异有统计学意义(P＜0.05),而稳定型心绞痛和冠状动脉单支病变的发生率分别为26.7％(23/86)、22.1％(19/86),显著低于非HCMV感染组的43.8％(7/16)、56.2％(9/16),差异有统计学意义(P＜0.05).结论 动脉粥样硬化病变患者中存在HCMV的高感染率,HCMV感染可能参与了动脉粥样硬化病变的发生、发展过程.“,”Objective To investigate the infection of human cytomegalovirus (HCMV) in patients with atherosclerosis and explore its clinical significance.Methods A total of 134 patients with atherosclerosis (observation group) including 102 patients with coronary heart disease (CHD) and 32 patients with non-CHD from December 2009 to April 2012 were enrolled in this study.The 102 patients with CHD were divided into HCMV infection group (86 cases) and non-HCMV infection group (16 cases).Another 40 healthy person were selected as control group.The carotid intima-media thickness (IMT) was assessed by ultrasonography.The serum HCMV-IgM was measured by enzyme-linked immunosorbent assay.Results The infection rate of HCMV in observation group was 77.6％ (104/134),which was higher than that of 37.5％(15/40) in control group(P ＜ 0.05).The infection rate of HCMV in CHD patients and non-CHD patients was 84.3％(86/102) and 56.2％(18/32),and there was significant difference (P ＜ 0.05).The carotid IMT in HCMV infected atherosclerosis patients was (1.31 + 0.28) mm,which was higher than that of (1.14 ± 0.21)mm in non-HCMV infected atherosclerosis patients (P ＜ 0.05).The incidence of myocardial infarction and multi-vessel lesion in HCMV infection group was higher than that in non-HCMV infection group [39.5％(34/86) vs.25.0％(4/16) and 43.0％(37/86) vs.18.8％(3/16)](P＜ 0.05).The incidence of stable angina pectoris and single-vessel lesion in HCMV infection group was lower than that in non-HCMV infection group [26.7％(23/86) vs.43.8％(7/16) and 22.1％(19/86) vs.56.2％(9/16)](P＜0.05).Conclusion The high-infection rate of HCMV is found in atherosclerosis patients,and it maybe have a close relationship with the occurrence and development of atherosclerosis.